mardi 27 novembre 2007
lundi 26 novembre 2007
Intergovernemental meeting on pandemic influenza preparedness: Sharing of influenza virus and access to vaccines and other benefits
Report by Dorothee Wenk-Dersch
This intergovernmental working group has its mandate from World Health Assembly (WHA).
There have already been negotiations previously, in particular at the “Singapore meeting”.
The main topic to treat of this conference is “virus sharing” and “benefit sharing”.
These issues are quite technical, so I will try to explain them:
As I could understand, the main conflict was between developing countries and developed ones.
The issue is that the outbreak of H5N1 (avian influenza, transmitting from bird [in this case particularly from chickens to farmers living close to them]) in the Asian Region.
WHO and developed countries have asked developing countries, where the virus H5N1 was found, to send it to the CC (research centres). So, Vietnam and also Indonesia have sent their virus to analyse them. Then, in Europe (Germany), and afterwards in the US, scientists were researching for a vaccine. Once they had found a vaccine in the US, commercial companies patented the virus, which has not happened until then! The consequence was that affected countries like Indonesia had to buy an expensive vaccine, and afterwards they knew, that it has been produced based on the virus they have sent (from Vietnam and Indonesia).
So their position was that this is an unfair system, exploiting affected countries. They where no longer willing to cooperate with research institutions, unless they accept benefit sharing, implying that they can only produce vaccins with the prior informed consent of the originating country (that has sent the virus sample).
The position of developed countries, particularly the US, later also the EU, was that this is unacceptable to them.
These positions have become entrenched, so neither of them wanted to give up their demands and showing not a lot of willingness in the prior process to this IGM to find a solid (and durable) solution.
The IGM worked from 20-23 November 2007.
The first day consisted in finding the chair and vice chairs. Jaden Holden from Australia was elected chair and Timor-Leste (A. Dick) was elected first vice chair. The procedure was to elect one vice chair for each of the five regions: SEARO, AMERO (E. Palacios, Mexico), EMERO (K. Ahmadi, Iran), AFRO (A. Nasidi, Nigeria) and EURO (S. Hodnesteen, Norway).
After that, the chair tried to help to find the appropriate working document, with the positions papers. The basis documents of the meeting were the following white papers (wp):
(see at Agenda A/PIP/IGM/+ Rev.1)
wp 1 (IGM/wp), wp 1 Rev.1, wp 2, wp 2 Rev.1,wp 3, wp 3 Rev.1
Dictionary, principles and operational aspects.
A/PHI/IGWG/2/2
A/PIP/IGM/5
A/PIP/IGM/6
You can find find all these documents at: http://www.who.int/gb/pip/
In the afternoon of the first day, the amount of work compared to the time available, turned out to be too high. So we had to split in a plenary and a working group. (Working group was lead by Nigeria). Days passed; there were negotiations, but no breakthrough!
I will focus my report on Friday 23, after the planned end of the meeting. That was from about 6 to 11pm. In my eyes it was the most important phase of the IGM:
The idea of the process was that the meeting will not be concluded, but suspend, and reconvened by an open ended working group which is open to all member states.
The recommendation made will go to the Executive Board (EB), to vehicle it to the WHA. (Where the mandate came from).
A one-page agreement was produced, which had to be agreed on in consensus.
There have been hard negotiations. Delegations, particularly Indonesia, have shown enormous goodwill. This exercise of showing goodwill without consulting to capitals was quite challenging for all delegations!
At about 8 o’clock, shuttle diplomacy began and despite of being tired and hungry, delegations have put all their energy in this process, especially to define an interim process.
Sometime later, negotiations seemed quite hopeless; it was considered deleting the most important paragraph about virus sharing, because consensus seemed impossible. But delegations continued, saying we didn’t make all that progress to delete it… !
..but still no agreement.
The chair was doing everything she could to make negotiation more comfortable by telling jokes and encouraging us. She told us that the director general is a fabulous singer.
So the director general of WHO, Dr. Margaret Chan, took the floor and spoke about all the work she put in that meeting, and that IGM was the conference where she attended the most time compared to all other things happening at WHO.
In this spirit she sang a song: “ know each other better, to like you and to work together”. Everybody applauded! Hope had come back to the room.
Some of the people gathered in two groups and had vigorous discussions. On one side was a group around EURO, and on the other side a group around SEARO (in particular Indonesia) centred around the director general.
Finally, the chair continued by taking the floor and giving it to the director general.
She read the agreement found in this difficult procedure.
Kenya took the floor to tell their unhappiness with leaving the African group out of the procedure from the beginning of the meeting. But the delegate stressed that he doesn’t want to oppose to an emerging consensus. He said that the African group was coming back to the chair next week with their comments.
Kenya emphasised that it is crucial that excluding a region like the AFRO region should never happened again.
The chair was thanking Kenya for that statement, responding that we all are learning on that process.
Some delegations took the floor to thank the chair, director general, the secretariat and the interpreters for their excellent work. They all had nice words for each other.
For me it was really a good experience to attend this conference. I learned a lot about WHO and influenza virus. It was a pleasure for me to represent Timor-Leste.
I could make some good contacts with the Indonesian delegation and in particular also the delegation of Thailand.
It was encouraging to see changing the situation from a zero-outcome to a real (as Thai delegate says) SOLID, outcome.
Some statement I won’t forget such as the statement of Portugal on behalf of herself: “If the virus works as slowly as we do, we won’t have a pandemia!!!”, or also the
Director general saying she is a 60 year old woman, “looking young from far away!” and comparing a facelifting with the reform of the 60 year old WHO system!
And of course the reminder of our SEARO region, “What will we do if there is a pandemia tomorrow? We don’t have any mechanism!”
If you have any question to me about WHO or some other subject, please feel free to send me an Email or leave a comment.
This intergovernmental working group has its mandate from World Health Assembly (WHA).
There have already been negotiations previously, in particular at the “Singapore meeting”.
The main topic to treat of this conference is “virus sharing” and “benefit sharing”.
These issues are quite technical, so I will try to explain them:
As I could understand, the main conflict was between developing countries and developed ones.
The issue is that the outbreak of H5N1 (avian influenza, transmitting from bird [in this case particularly from chickens to farmers living close to them]) in the Asian Region.
WHO and developed countries have asked developing countries, where the virus H5N1 was found, to send it to the CC (research centres). So, Vietnam and also Indonesia have sent their virus to analyse them. Then, in Europe (Germany), and afterwards in the US, scientists were researching for a vaccine. Once they had found a vaccine in the US, commercial companies patented the virus, which has not happened until then! The consequence was that affected countries like Indonesia had to buy an expensive vaccine, and afterwards they knew, that it has been produced based on the virus they have sent (from Vietnam and Indonesia).
So their position was that this is an unfair system, exploiting affected countries. They where no longer willing to cooperate with research institutions, unless they accept benefit sharing, implying that they can only produce vaccins with the prior informed consent of the originating country (that has sent the virus sample).
The position of developed countries, particularly the US, later also the EU, was that this is unacceptable to them.
These positions have become entrenched, so neither of them wanted to give up their demands and showing not a lot of willingness in the prior process to this IGM to find a solid (and durable) solution.
The IGM worked from 20-23 November 2007.
The first day consisted in finding the chair and vice chairs. Jaden Holden from Australia was elected chair and Timor-Leste (A. Dick) was elected first vice chair. The procedure was to elect one vice chair for each of the five regions: SEARO, AMERO (E. Palacios, Mexico), EMERO (K. Ahmadi, Iran), AFRO (A. Nasidi, Nigeria) and EURO (S. Hodnesteen, Norway).
After that, the chair tried to help to find the appropriate working document, with the positions papers. The basis documents of the meeting were the following white papers (wp):
(see at Agenda A/PIP/IGM/+ Rev.1)
wp 1 (IGM/wp), wp 1 Rev.1, wp 2, wp 2 Rev.1,wp 3, wp 3 Rev.1
Dictionary, principles and operational aspects.
A/PHI/IGWG/2/2
A/PIP/IGM/5
A/PIP/IGM/6
You can find find all these documents at: http://www.who.int/gb/pip/
In the afternoon of the first day, the amount of work compared to the time available, turned out to be too high. So we had to split in a plenary and a working group. (Working group was lead by Nigeria). Days passed; there were negotiations, but no breakthrough!
I will focus my report on Friday 23, after the planned end of the meeting. That was from about 6 to 11pm. In my eyes it was the most important phase of the IGM:
The idea of the process was that the meeting will not be concluded, but suspend, and reconvened by an open ended working group which is open to all member states.
The recommendation made will go to the Executive Board (EB), to vehicle it to the WHA. (Where the mandate came from).
A one-page agreement was produced, which had to be agreed on in consensus.
There have been hard negotiations. Delegations, particularly Indonesia, have shown enormous goodwill. This exercise of showing goodwill without consulting to capitals was quite challenging for all delegations!
At about 8 o’clock, shuttle diplomacy began and despite of being tired and hungry, delegations have put all their energy in this process, especially to define an interim process.
Sometime later, negotiations seemed quite hopeless; it was considered deleting the most important paragraph about virus sharing, because consensus seemed impossible. But delegations continued, saying we didn’t make all that progress to delete it… !
..but still no agreement.
The chair was doing everything she could to make negotiation more comfortable by telling jokes and encouraging us. She told us that the director general is a fabulous singer.
So the director general of WHO, Dr. Margaret Chan, took the floor and spoke about all the work she put in that meeting, and that IGM was the conference where she attended the most time compared to all other things happening at WHO.
In this spirit she sang a song: “ know each other better, to like you and to work together”. Everybody applauded! Hope had come back to the room.
Some of the people gathered in two groups and had vigorous discussions. On one side was a group around EURO, and on the other side a group around SEARO (in particular Indonesia) centred around the director general.
Finally, the chair continued by taking the floor and giving it to the director general.
She read the agreement found in this difficult procedure.
Kenya took the floor to tell their unhappiness with leaving the African group out of the procedure from the beginning of the meeting. But the delegate stressed that he doesn’t want to oppose to an emerging consensus. He said that the African group was coming back to the chair next week with their comments.
Kenya emphasised that it is crucial that excluding a region like the AFRO region should never happened again.
The chair was thanking Kenya for that statement, responding that we all are learning on that process.
Some delegations took the floor to thank the chair, director general, the secretariat and the interpreters for their excellent work. They all had nice words for each other.
For me it was really a good experience to attend this conference. I learned a lot about WHO and influenza virus. It was a pleasure for me to represent Timor-Leste.
I could make some good contacts with the Indonesian delegation and in particular also the delegation of Thailand.
It was encouraging to see changing the situation from a zero-outcome to a real (as Thai delegate says) SOLID, outcome.
Some statement I won’t forget such as the statement of Portugal on behalf of herself: “If the virus works as slowly as we do, we won’t have a pandemia!!!”, or also the
Director general saying she is a 60 year old woman, “looking young from far away!” and comparing a facelifting with the reform of the 60 year old WHO system!
And of course the reminder of our SEARO region, “What will we do if there is a pandemia tomorrow? We don’t have any mechanism!”
If you have any question to me about WHO or some other subject, please feel free to send me an Email or leave a comment.
mercredi 24 octobre 2007
WHO Expert Meeting on the Selection and Use of Essential Medecines
Wednesday, 24 October 2007
After a brief introduction, the Chair person gave the floor to Dr howard Zucker, Assistant Director-General, Health Technology and Pharmaceuticals. He was very brief an pointed out the main issues of essential medicines: what is the appropriate dose for children under 12; malaria ; tuberculosis ; filling out the gaps …
The Chair then gave the floor to Dr Hans V. Hogerzeil for general remarks before the presentation of several reports. He stressed out the 30 years of Essential Medicines (1977-2007).
What have been done?
- WHO notes that there are a cumulative number of national policies.
- In 1959, 156 countries with EDLS.
- The number of countries with updated EMLs seems to decrease.
- The number of people with access to essential drugs has nearly double in 20 years. More regular access to medicines. BUT in 1977, 2 billions people over 4 didn’t have regular access to medicines and today the number didn’t decreased. There is still 2 billions people (over 7) who doesn’t have regular access to medicines. 1/2, 1/3.
- Self assessed access to essential medicines in LIC and MICs is increasing.
Essential Medicines has become and has remained universal and stands firmly for common sense, equity, pro-poor, pragmatic approach, good governance...
Dr. Hogerzeil also stresses out the following achievements on medicine policies:
- Guidelines for national drug policies.
- More than 100 countries have developed national need policies.
- Innovation of public health thinking (impact trips on access to new essential medicines, WHO/UN pre-qualification project, global medicine prices survey methodology for NGOs, access to essential medicine as part of Human Rights)
- Thousands of peoples trained in medicine policies, quality assurance.
There is also according to Dr. Hogerzeil an improvement on the access of medicines: source and prices of medicine, best prices in supply management, medicine prices survey over 50 countries, global standards for medicine donation, improvement of national access indicators… thus the challenges are to promote vertical disease-oriented supply program by the donors, the need for horizontal medicine system in insufficiently medicine access.
Another issue was one of the quality of essential medicines. WHO ensure quality norms and standards for new essential medicines. International pharmacopoeia has become a primary global reference for a number of essential medicines. And there is a WHO and UN pre-qualification project. The model list of essential medicines is updated every 2 years since 1977 and there is a model list for children since 2007.
Finally the issue of traditional medicines is also a very important one. WHO established a stronger scientific base for safety and efficacy of traditional medicines, guidelines for registration of traditional medicines, increasing number of countries with TM/CAM policies.
Dr. Suzanne Hill quickly presented the updated process of the expert committee. She listed meetings that have already occurred on the related field and then stressed out some key issues that need to be manage by the committee:
- process and terms of reference for the subcommittee.
- Prepare a list of medicines for children.
- Determine suitability criteria for dosage forms of medicine for children.
- Identify the clinical needs of children under 12.
Mr. Andy Gray presented the Report from the First Meeting of the Subcommmittee of the Expert Committee on the Selection and Use of Essential Medicines.
The first issue deals with the scope of the provisional list:
- for children up to 12.
- Including Neonates (oral liquid forms noting problem with them)
- For consistency based on essential medicines (it may be missing some specific diseases, generally covers burden of diseases)
- Problem with poverty of data (need to indicate limitation of data and restriction).
Mr. Gray also talked about the main causes of death of children under 5 which are : malaria, pneumonia, aids, injuries, measles, diarrhoeal, neonatal severe infections, other neonatal causes…
The areas of significant difficulties are the following: neonates are noting burden of diseases, children with TB, neglected tropical diseases, respiratory diseases (infection and wheeze), chronically diseases, cardiac, diabetes, specific antibiotics, oncology, pain management.
After this presentation the president gave the floor but no one took it so he invited Dr. Suzanne Hill and Dr. Elizabeth Zisovska to present the report on preliminary work on neonates.
The main principles:
- WHO support to primary and first level care of neonates.
- Secondary and tertiary care option.
- Priority condition and burden of disease.
- Transitional middle income countries.
On the 2nd and 3rd level:
- problems related to pre maturity (respiratory…)
- cardiovascular problems, infections, asphyxia…
The last report presented was done by Dr. Hill again on research priorities:
The meeting objectives:
- to develop a list of research priority for improving essential medicines.
- To develop a strategy for promoting this global research agenda.
- To identify research question from an existing list of possible review.
The very high priorities:
- review of the medicine used for TB in children.
- Drugs for a line treatment of TB in children.
- Evidence of efficacy and safety of use of essential medicines for children below the licensing age limit.
- Application for inclusion of oral cephalosporin for use in children.
For a conclusion the chair made a brief statement and the main point was that the dosage should not only depend on the age but also on the weight. The latter can vary widely between developed countries and sub-Saharan countries.
Ismaila Pedro FAYE
After a brief introduction, the Chair person gave the floor to Dr howard Zucker, Assistant Director-General, Health Technology and Pharmaceuticals. He was very brief an pointed out the main issues of essential medicines: what is the appropriate dose for children under 12; malaria ; tuberculosis ; filling out the gaps …
The Chair then gave the floor to Dr Hans V. Hogerzeil for general remarks before the presentation of several reports. He stressed out the 30 years of Essential Medicines (1977-2007).
What have been done?
- WHO notes that there are a cumulative number of national policies.
- In 1959, 156 countries with EDLS.
- The number of countries with updated EMLs seems to decrease.
- The number of people with access to essential drugs has nearly double in 20 years. More regular access to medicines. BUT in 1977, 2 billions people over 4 didn’t have regular access to medicines and today the number didn’t decreased. There is still 2 billions people (over 7) who doesn’t have regular access to medicines. 1/2, 1/3.
- Self assessed access to essential medicines in LIC and MICs is increasing.
Essential Medicines has become and has remained universal and stands firmly for common sense, equity, pro-poor, pragmatic approach, good governance...
Dr. Hogerzeil also stresses out the following achievements on medicine policies:
- Guidelines for national drug policies.
- More than 100 countries have developed national need policies.
- Innovation of public health thinking (impact trips on access to new essential medicines, WHO/UN pre-qualification project, global medicine prices survey methodology for NGOs, access to essential medicine as part of Human Rights)
- Thousands of peoples trained in medicine policies, quality assurance.
There is also according to Dr. Hogerzeil an improvement on the access of medicines: source and prices of medicine, best prices in supply management, medicine prices survey over 50 countries, global standards for medicine donation, improvement of national access indicators… thus the challenges are to promote vertical disease-oriented supply program by the donors, the need for horizontal medicine system in insufficiently medicine access.
Another issue was one of the quality of essential medicines. WHO ensure quality norms and standards for new essential medicines. International pharmacopoeia has become a primary global reference for a number of essential medicines. And there is a WHO and UN pre-qualification project. The model list of essential medicines is updated every 2 years since 1977 and there is a model list for children since 2007.
Finally the issue of traditional medicines is also a very important one. WHO established a stronger scientific base for safety and efficacy of traditional medicines, guidelines for registration of traditional medicines, increasing number of countries with TM/CAM policies.
Dr. Suzanne Hill quickly presented the updated process of the expert committee. She listed meetings that have already occurred on the related field and then stressed out some key issues that need to be manage by the committee:
- process and terms of reference for the subcommittee.
- Prepare a list of medicines for children.
- Determine suitability criteria for dosage forms of medicine for children.
- Identify the clinical needs of children under 12.
Mr. Andy Gray presented the Report from the First Meeting of the Subcommmittee of the Expert Committee on the Selection and Use of Essential Medicines.
The first issue deals with the scope of the provisional list:
- for children up to 12.
- Including Neonates (oral liquid forms noting problem with them)
- For consistency based on essential medicines (it may be missing some specific diseases, generally covers burden of diseases)
- Problem with poverty of data (need to indicate limitation of data and restriction).
Mr. Gray also talked about the main causes of death of children under 5 which are : malaria, pneumonia, aids, injuries, measles, diarrhoeal, neonatal severe infections, other neonatal causes…
The areas of significant difficulties are the following: neonates are noting burden of diseases, children with TB, neglected tropical diseases, respiratory diseases (infection and wheeze), chronically diseases, cardiac, diabetes, specific antibiotics, oncology, pain management.
After this presentation the president gave the floor but no one took it so he invited Dr. Suzanne Hill and Dr. Elizabeth Zisovska to present the report on preliminary work on neonates.
The main principles:
- WHO support to primary and first level care of neonates.
- Secondary and tertiary care option.
- Priority condition and burden of disease.
- Transitional middle income countries.
On the 2nd and 3rd level:
- problems related to pre maturity (respiratory…)
- cardiovascular problems, infections, asphyxia…
The last report presented was done by Dr. Hill again on research priorities:
The meeting objectives:
- to develop a list of research priority for improving essential medicines.
- To develop a strategy for promoting this global research agenda.
- To identify research question from an existing list of possible review.
The very high priorities:
- review of the medicine used for TB in children.
- Drugs for a line treatment of TB in children.
- Evidence of efficacy and safety of use of essential medicines for children below the licensing age limit.
- Application for inclusion of oral cephalosporin for use in children.
For a conclusion the chair made a brief statement and the main point was that the dosage should not only depend on the age but also on the weight. The latter can vary widely between developed countries and sub-Saharan countries.
Ismaila Pedro FAYE
jeudi 24 mai 2007
Final Report
The 60th WHA was held in Geneva from 14th to 23rd May 2007. The Assembly has been efficent thanks to the good will of delegations and the work of both Committe A and B. The 1st Assembly under the new DG Margaret Chan approved the largest-ever budget for the Organization and adopted a record number of resolutions on public health issues and on the technical and administrative work of WHO.
In the closing Item, Dr. Robinson, chairman of Committe A took the floor to thank the delegations fir the good work accomplished during this 60th WHA. He particularly noted the constructive atmosphere in the debate. His committee adopted 15 resolutions. 2 on the strategic medium plan and 13 on technical and healt issues. Only 2 working group were needed to discuss the draft reports. Dr. Robinson congratulates the Presidency and the DG Margaret Chan for her first WHA as director general.
Thomas Zeltner, the president of Committee B and Swiss secretary of state for Public health, addresses the audience to acknowledge the work of the Assembly. He precised, that despite the comments, there is not yet a complete ban for smoking in public places in Switzerland, but a proposal is submitted to the Parliament and shall be submitted to approval. M. Zeltner said that his committee has been very efficient and that its rapid work allowed to transfer some items from committee A. He thanked all delegations and the work of the Secretariat, the presidency, WHO staff and DG Dr. Chan.
Decisions and issues discussed at the 60th World Health Assembly
Member States agreed a resolution which will help all countries better prepare for the global public health threat which an influenza pandemic presents. The resolution, "Sharing of Influenza viruses and access to vaccines and other benefits," restates the general principles of the necessity of sharing both in the preparations for an influenza pandemic and the benefits that will flow from improved international cooperation and preparation, such as greater quantities of and equitable access to H5N1 and pandemic vaccines.
The resolution requests WHO to establish an international stockpile of vaccines for H5N1 or other influenza viruses of pandemic potential, and to formulate mechanisms and guidelines aimed at ensuring fair and equitable distribution of pandemic-influenza vaccines at affordable prices in the event of a pandemic.
It also tasks an interdisciplinary working group with drawing up new Terms of Reference (TORs) for the WHO Influenza Collaborating Centre Network, and its H5 reference laboratories, for the sharing of influenza viruses. The new TORs will take into account the origin of influenza viruses going into the WHO Global Influenza Surveillance Network, and will make their use more transparent. Once finalized, these TORs will be submitted to a special Intergovernmental Meeting of WHO Member States and regional economic organizations.
The Assembly reached a last-minute agreement on public health, innovation and intellectual property. The resolution expressed appreciation to the Director-General for her commitment to the process of the Intergovernmental Working Group on the issue and encouraged her to guide the process to draw up a global strategy and plan of action. The resolution also requested the Director-General to provide technical and policy support to countries.
The Assembly approved a budget for 2008-2009 of $4.2 billion, an increase of nearly $1 billion from the $3.3 billion approved for 2006-2007. The new budget highlights the continued trend of increased investment in global public health. For WHO it means being able to provide more support to countries, in close collaboration with UN and other partners. For the first time, this budget is part of a six-year strategic plan for the Organization, which Member States also adopted at the Assembly.
Member States expressed their concern that malaria continues to cause more than one million preventable deaths every year. The Assembly passed a resolution to intensify access to affordable, safe and effective antimalarial combination treatments, to intermittent preventive treatment in pregnancies, to insecticide treated mosquito nets, and indoor residual spraying for malaria control with suitable and safe insecticide. Member States requested that donors adjust their policies so as to progressively cease to fund the provision and distribution of oral artemisinin monotherapies, and to join in campaigns to prohibit the marketing, distribution and use of counterfeit antimalarial medicines.
All Member States were urged to develop and implement long-term plans for tuberculosis (TB) prevention and control, in line with the WHO Stop TB Strategy. The actions the resolution are aimed at accelerating progress towards halving TB deaths and prevalence by 2015, through the full implementation of the Global Plan to Stop TB, 2006-2015. WHO is requested to strengthen its support to countries affected by TB, in particular those heavily affected by Multidrug-resistant and Extensively Drug-Resistant TB (MD/XDR-TB) as well as TB/HIV.
Indigenous polio survives in parts of only four countries. Member States resolved to step up their efforts to eradicate the virus swiftly, while taking steps to minimize the risk of its international spread. Stressing the financial and humanitarian gains to be made from completing eradication and the ongoing dividends of the highly-developed polio infrastructure, the Director-General presented the 'Case for Completing Polio Eradication', outlining a clear justification for the international donor community to rapidly fill a global funding gap of US$540 million for 2007-2008. Insufficient funding is currently imperilling the 20-year, US$5.3 billion international effort.
The Assembly adopted a resolution on integrating gender analysis and actions into the work of WHO, demonstrating the importance Member States place on including gender perspectives such as disaggregation of data based on sex in all publications and reports.
The WHA adopted a resolution expressing concern over the continuous deterioration of the health and economic conditions of the populations in the occupied Palestinian territory. The need for universal coverage of health services was reaffirmed while recognizing that the acute shortage of financial and medical resources is jeopardizing access of the population to curative and preventive services. The Assembly requested the WHO Director-General to report on the health and economic situation in the occupied Palestinian territory and to continue to provide the necessary technical assistance to meet the health needs of the Palestinians.
The Assembly passed a resolution on better medicines for children, requesting the Director-General to undertake a program of work to improve access to essential medicines for children. This year, WHO will develop a Model List of Essential Medicines for Children, as well as evidence-based medicines information for prescribers and carers, and identify key research and development requirements for producing better medicines for children.
In a resolution on health technologies, in particular medical devices, the Assembly urged Member States to draw up national guidelines and plans for the assessment, procurement and management of technologies used in healthcare.
A resolution on rational use of medicines promotes an integrated, health systems approach to promoting more appropriate use of medicines - specifically, national multidisciplinary bodies to monitor medicines use and promote rational use. The Assembly agreed that a comprehensive review of all research undertaken on the variola virus, which causes smallpox, be undertaken beginning in 2010. The WHA asked that the results of that research - and conclusions concerning the need for any further research - be presented to the 64th World Health Assembly in 2011. The economic burden of oral disease is predicted to grow rapidly worldwide, particularly in disadvantaged and poor populations, unless oral preventive programmes are implemented. The WHA resolution urges WHO to provide advice and technical support for strengthening oral health programmes at country, regional and global levels, in collaboration with other UN organizations, WHO collaborating centres and NGOs.
The WHA passed a resolution urging Member States and the Secretariat to increase investment in, and strengthen efforts towards health promotion as the cornerstone of primary health care and a core function of public health.
The Assembly adopted a resolution on emergency trauma care systems, which draws the attention of governments to the need to strengthen pre-hospital and emergency trauma care systems (including mass casualty management efforts) and describes a number of steps governments could take. It also invites WHO to scale up its efforts to support countries.
Member States approved the resolution on strengthening of health information systems and enhancing WHO's work on health statistics in general. They also called on the DG to strengthen the information and evidence culture of WHO itself, and ensure the use of accurate and timely health statistics in order to generate evidence for major policy decisions and recommendations within WHO.
Member States approved a resolution and reiterated the importance of a coherent research strategy for WHO which will help to disseminate the outcomes of research and its utilization in decision- and policy-making for more effective health policies.
Member States approved a resolution on the control of leishmaniasis, which is recognized as one of the most neglected tropical diseases. Member States were urged to encourage research on leishmaniasis control, to identify appropriate and effective methods of control of vectors and reservoirs and find alternative safe, effective and affordable medicines.
The Assembly endorsed the Global Plan of Action on Workers' Health, which aims to devise policy instruments on workers health; protect and promote health at the workplace; improve the performance of and access to occupational health services; provide and communicate evidence for preventive action; and incorporate workers health into other policies. During this year's opening plenary, the United Nations declared the Palais des Nations a smoke-free environment indoors, recognizing the major contribution of tobacco use to non-communicable diseases and preventable, premature death. A progress report to the Assembly describes noncommunicable disease activities in advocacy, surveillance and population-based prevention since the year 2000. A resolution urges Member States to strengthen national efforts in noncommunicable disease (NCD) prevention and control and also calls for an action plan for the prevention and control of NCDs to be presented to the 61st WHA in 2008.
The Assembly held lengthy discussions on public-health problems caused by the harmful use of alcohol. Delegates agreed that the issue will be discussed again at the WHO Executive Board in January, 2008.
In the closing Item, Dr. Robinson, chairman of Committe A took the floor to thank the delegations fir the good work accomplished during this 60th WHA. He particularly noted the constructive atmosphere in the debate. His committee adopted 15 resolutions. 2 on the strategic medium plan and 13 on technical and healt issues. Only 2 working group were needed to discuss the draft reports. Dr. Robinson congratulates the Presidency and the DG Margaret Chan for her first WHA as director general.
Thomas Zeltner, the president of Committee B and Swiss secretary of state for Public health, addresses the audience to acknowledge the work of the Assembly. He precised, that despite the comments, there is not yet a complete ban for smoking in public places in Switzerland, but a proposal is submitted to the Parliament and shall be submitted to approval. M. Zeltner said that his committee has been very efficient and that its rapid work allowed to transfer some items from committee A. He thanked all delegations and the work of the Secretariat, the presidency, WHO staff and DG Dr. Chan.
Decisions and issues discussed at the 60th World Health Assembly
Member States agreed a resolution which will help all countries better prepare for the global public health threat which an influenza pandemic presents. The resolution, "Sharing of Influenza viruses and access to vaccines and other benefits," restates the general principles of the necessity of sharing both in the preparations for an influenza pandemic and the benefits that will flow from improved international cooperation and preparation, such as greater quantities of and equitable access to H5N1 and pandemic vaccines.
The resolution requests WHO to establish an international stockpile of vaccines for H5N1 or other influenza viruses of pandemic potential, and to formulate mechanisms and guidelines aimed at ensuring fair and equitable distribution of pandemic-influenza vaccines at affordable prices in the event of a pandemic.
It also tasks an interdisciplinary working group with drawing up new Terms of Reference (TORs) for the WHO Influenza Collaborating Centre Network, and its H5 reference laboratories, for the sharing of influenza viruses. The new TORs will take into account the origin of influenza viruses going into the WHO Global Influenza Surveillance Network, and will make their use more transparent. Once finalized, these TORs will be submitted to a special Intergovernmental Meeting of WHO Member States and regional economic organizations.
The Assembly reached a last-minute agreement on public health, innovation and intellectual property. The resolution expressed appreciation to the Director-General for her commitment to the process of the Intergovernmental Working Group on the issue and encouraged her to guide the process to draw up a global strategy and plan of action. The resolution also requested the Director-General to provide technical and policy support to countries.
The Assembly approved a budget for 2008-2009 of $4.2 billion, an increase of nearly $1 billion from the $3.3 billion approved for 2006-2007. The new budget highlights the continued trend of increased investment in global public health. For WHO it means being able to provide more support to countries, in close collaboration with UN and other partners. For the first time, this budget is part of a six-year strategic plan for the Organization, which Member States also adopted at the Assembly.
Member States expressed their concern that malaria continues to cause more than one million preventable deaths every year. The Assembly passed a resolution to intensify access to affordable, safe and effective antimalarial combination treatments, to intermittent preventive treatment in pregnancies, to insecticide treated mosquito nets, and indoor residual spraying for malaria control with suitable and safe insecticide. Member States requested that donors adjust their policies so as to progressively cease to fund the provision and distribution of oral artemisinin monotherapies, and to join in campaigns to prohibit the marketing, distribution and use of counterfeit antimalarial medicines.
All Member States were urged to develop and implement long-term plans for tuberculosis (TB) prevention and control, in line with the WHO Stop TB Strategy. The actions the resolution are aimed at accelerating progress towards halving TB deaths and prevalence by 2015, through the full implementation of the Global Plan to Stop TB, 2006-2015. WHO is requested to strengthen its support to countries affected by TB, in particular those heavily affected by Multidrug-resistant and Extensively Drug-Resistant TB (MD/XDR-TB) as well as TB/HIV.
Indigenous polio survives in parts of only four countries. Member States resolved to step up their efforts to eradicate the virus swiftly, while taking steps to minimize the risk of its international spread. Stressing the financial and humanitarian gains to be made from completing eradication and the ongoing dividends of the highly-developed polio infrastructure, the Director-General presented the 'Case for Completing Polio Eradication', outlining a clear justification for the international donor community to rapidly fill a global funding gap of US$540 million for 2007-2008. Insufficient funding is currently imperilling the 20-year, US$5.3 billion international effort.
The Assembly adopted a resolution on integrating gender analysis and actions into the work of WHO, demonstrating the importance Member States place on including gender perspectives such as disaggregation of data based on sex in all publications and reports.
The WHA adopted a resolution expressing concern over the continuous deterioration of the health and economic conditions of the populations in the occupied Palestinian territory. The need for universal coverage of health services was reaffirmed while recognizing that the acute shortage of financial and medical resources is jeopardizing access of the population to curative and preventive services. The Assembly requested the WHO Director-General to report on the health and economic situation in the occupied Palestinian territory and to continue to provide the necessary technical assistance to meet the health needs of the Palestinians.
The Assembly passed a resolution on better medicines for children, requesting the Director-General to undertake a program of work to improve access to essential medicines for children. This year, WHO will develop a Model List of Essential Medicines for Children, as well as evidence-based medicines information for prescribers and carers, and identify key research and development requirements for producing better medicines for children.
In a resolution on health technologies, in particular medical devices, the Assembly urged Member States to draw up national guidelines and plans for the assessment, procurement and management of technologies used in healthcare.
A resolution on rational use of medicines promotes an integrated, health systems approach to promoting more appropriate use of medicines - specifically, national multidisciplinary bodies to monitor medicines use and promote rational use. The Assembly agreed that a comprehensive review of all research undertaken on the variola virus, which causes smallpox, be undertaken beginning in 2010. The WHA asked that the results of that research - and conclusions concerning the need for any further research - be presented to the 64th World Health Assembly in 2011. The economic burden of oral disease is predicted to grow rapidly worldwide, particularly in disadvantaged and poor populations, unless oral preventive programmes are implemented. The WHA resolution urges WHO to provide advice and technical support for strengthening oral health programmes at country, regional and global levels, in collaboration with other UN organizations, WHO collaborating centres and NGOs.
The WHA passed a resolution urging Member States and the Secretariat to increase investment in, and strengthen efforts towards health promotion as the cornerstone of primary health care and a core function of public health.
The Assembly adopted a resolution on emergency trauma care systems, which draws the attention of governments to the need to strengthen pre-hospital and emergency trauma care systems (including mass casualty management efforts) and describes a number of steps governments could take. It also invites WHO to scale up its efforts to support countries.
Member States approved the resolution on strengthening of health information systems and enhancing WHO's work on health statistics in general. They also called on the DG to strengthen the information and evidence culture of WHO itself, and ensure the use of accurate and timely health statistics in order to generate evidence for major policy decisions and recommendations within WHO.
Member States approved a resolution and reiterated the importance of a coherent research strategy for WHO which will help to disseminate the outcomes of research and its utilization in decision- and policy-making for more effective health policies.
Member States approved a resolution on the control of leishmaniasis, which is recognized as one of the most neglected tropical diseases. Member States were urged to encourage research on leishmaniasis control, to identify appropriate and effective methods of control of vectors and reservoirs and find alternative safe, effective and affordable medicines.
The Assembly endorsed the Global Plan of Action on Workers' Health, which aims to devise policy instruments on workers health; protect and promote health at the workplace; improve the performance of and access to occupational health services; provide and communicate evidence for preventive action; and incorporate workers health into other policies. During this year's opening plenary, the United Nations declared the Palais des Nations a smoke-free environment indoors, recognizing the major contribution of tobacco use to non-communicable diseases and preventable, premature death. A progress report to the Assembly describes noncommunicable disease activities in advocacy, surveillance and population-based prevention since the year 2000. A resolution urges Member States to strengthen national efforts in noncommunicable disease (NCD) prevention and control and also calls for an action plan for the prevention and control of NCDs to be presented to the 61st WHA in 2008.
The Assembly held lengthy discussions on public-health problems caused by the harmful use of alcohol. Delegates agreed that the issue will be discussed again at the WHO Executive Board in January, 2008.
mercredi 23 mai 2007
Wednesday 23rd, MAY 2007
Committee A
The draft fifth report of Committee A is examined. The draft document A60/61 contains seven resolutions that are entitled: 12.14 Health systems: emergency-care systems, 12.8 Prevention and control of noncommunicable diseases: implementation of the global strategy, 12.11 Health promotion in a globalized world, 12.12 Integrating gender analysis and actions into the work of WHO: draft strategy, 12.13 Workers’ health: draft global plan of action, 12.15 Strengthening of health information systems, 12.1 Pandemic influenza preparedness: sharing of influenza viruses and access to vaccines and other benefits.
This draft is adopted.
Item 12.7 on Evidence-based strategies and interventions to reduce alcohol-related harm is discussed. Doctor Blumfield’s stated that there was a great interest on the topic as there were 5 changes of the resolution through the amendments. Although there was no sufficient time to work through the paper, the members showed flexibility and good will to write a short paper to work on, which was conference paper 15. But consensus remained hard to reach. Few corrections are made according to what has been agreed on. Resolution will be submitted to the Executive Board. The delegate representative of Cuba said that some changes of the working group had not been taken into account by the Doctor Chairman of the working group. According to the Chairman, the Executive Board will be studying the issue. Brazil reminds that this issue is very important and expresses its will to act immediately. Be more dynamic on this topic that cannot wait longer. Progress has to be made in Sweden’s view, and the conference paper 15.1 doesn’t reflect their will anymore, they propose the reintroduction of paper 10. Cuba finally agrees with paper 15.1 going to the EB. The DGO proposed its version; there were no objections to it.
Work of the 60th World Health Assembly is ending today. The Chairman thanks all the members for their contributions to the debates of this Committee, for the solidarity and collaboration between the member states during the assembly which helped to enhance the work of the World Health Assembly. Thanks were expressed to Director General Mrs Chan, the representatives of the secretariat, the vice presidents, and the “rapporteur” for their support, who were very professional. Interpreters and translators were very useful as well for the communication between member states, thanks to them.
Delegate of Senegal’s had the last word. He expressed his admiration for the way the work has been achieved. According to him courtesy, patience, constancy and a sense of compromise were present through the Committee. And the Chairman was specifically thanked for his work by the Senegalese delegate as he represented Madagascar and the African Region.
Therefore a very good overall impression had emerged from the work of the fourteenth meetings of Committee B during the WHA.
COMMITTEE B
Draft fourth report of Committee B
Document (draft) A60/62, containing one resolution entitled:
Health technologies
After a consultation of the assembly, no opposition was expressed to the adoption then declared by the Chairperson of the committee.
Item 12 (continued) Technical and health matters
Item 12.20 (continued) Public health, innovation and intellectual property: progress made by the Intergovernmental Working Group
Documents A60/27 and A60/B/Conf.Paper No.3 Rev.2
The Distinguished Delegate of Namibia presented the result of the work of the drafting group on the issue of Public health, innovation and intellectual property. He congratulated his co-workers in the draft group underlying the fact that the strength of such a group came from its diversity. He concluded by underlying the remaining sentence in brackets from line 3 to line 5 in paragraph 3 of operative clauses.
The efforts of the D.D. of Namibia were also thanked by the Chairperson.
The floor was then opened to comments and discussion. The D.D. of the U.S.A. took first the floor saying that his delegation was ready to make consensus provided certain changes in the text of the draft resolution. The D.D. of the U.S.A. proposed in fact several modifications:
• Preamble part of the draft resolution: change proposed in §2 (expression "diagnostic tools" on line 2 should be removed, becoming: "diagnostic TRIPS"). Such proposal received the support of the Australian Delegation.
• Operative clauses: §2 (second line, the expression "continue to" should precede the end of the sentence; "and continue to provide adequate resources to WHO"), §3.4 (a reformulation of the whole sentence is proposed). This last proposal was supported by the D.D. of Japan saying that the Delegation of Japan could not accept the statement in brackets.
The changes proposed by the American Delegation raised the opposition of several states among which were: Brazil, Chile, Kenya on behalf of the 46 African States, Thailand. The Delegation of Switzerland proposed to replace §3.4 in the text and to underlying that a compromise was reached yesterday. The Delegation has previously stated that the drat resolution, a very important and complex text was the result of a hazardous process and he added that the efforts done should not be underscored. According to his Delegation, the proposal from the D.D. of the U.S.A. can improve the reading of the text but are absolutely different from the draft document. He asked for a withdrawal of U.S.A.'s proposal.
Finally, as no agreement seemed to be reach between the two different positions the Chairman proposed to adopt the draft resolution as it was including the change on §2 of preamble. The D.D. of the U.S.A. declared that his Delegation reserved itself the right to express its opposition during the plenary.
The Resolution was adopted.
Draft fifth report of Committee B
The draft report was adopted without any comment or opposition in the committee.
Plenary Session
Item 8 : the draft reports of Committtee A (3rd, 4th, 5th and 6th) were adopted. Reports of Committee B (2nd, 3rd, 4th, 5th) were adopted.
However the US delegation declared that it couldn’t accepte the resolution contained in the 5th report of committee B : Public health, innovation and intellectual property as announced, as it cannot be considered as a consensus text. However the US did not intend to block to process.
In the closing Item, Dr. Robinson, chairman of Committe A took the floor to thank the delagations fir the good work accomplished during this 60th WHA. He particularly noted the constructive atmosphere in the dabate. His committe adopted 15 resolutions. 2 on the strategic medium plan and 13 on technical and healt issues. Only 2 working group were needed to discuss the draft reports. Dr. Robinson congratulate the Presidency and the DG Margaret Chan for her first WHA as director general.
Thomas Zeltner, the president of Committee B and swiss secretary of state for Public health, adresses the audience to acknoledge the work of the Assembly. He precised, that depite the comments, there is not yet a complete ban for smoking in public places in Switzerland, but a poposal is submitted to the Parliament and shall be submitted to approval. M. Zeltner said that his committee has been very effiecient and that its rapid work allowed to transfert some items from committee A. He thanked all delegations and the work of the Secretariat, the presidency, WHO staff and DG Dr. Chan.
The draft fifth report of Committee A is examined. The draft document A60/61 contains seven resolutions that are entitled: 12.14 Health systems: emergency-care systems, 12.8 Prevention and control of noncommunicable diseases: implementation of the global strategy, 12.11 Health promotion in a globalized world, 12.12 Integrating gender analysis and actions into the work of WHO: draft strategy, 12.13 Workers’ health: draft global plan of action, 12.15 Strengthening of health information systems, 12.1 Pandemic influenza preparedness: sharing of influenza viruses and access to vaccines and other benefits.
This draft is adopted.
Item 12.7 on Evidence-based strategies and interventions to reduce alcohol-related harm is discussed. Doctor Blumfield’s stated that there was a great interest on the topic as there were 5 changes of the resolution through the amendments. Although there was no sufficient time to work through the paper, the members showed flexibility and good will to write a short paper to work on, which was conference paper 15. But consensus remained hard to reach. Few corrections are made according to what has been agreed on. Resolution will be submitted to the Executive Board. The delegate representative of Cuba said that some changes of the working group had not been taken into account by the Doctor Chairman of the working group. According to the Chairman, the Executive Board will be studying the issue. Brazil reminds that this issue is very important and expresses its will to act immediately. Be more dynamic on this topic that cannot wait longer. Progress has to be made in Sweden’s view, and the conference paper 15.1 doesn’t reflect their will anymore, they propose the reintroduction of paper 10. Cuba finally agrees with paper 15.1 going to the EB. The DGO proposed its version; there were no objections to it.
Work of the 60th World Health Assembly is ending today. The Chairman thanks all the members for their contributions to the debates of this Committee, for the solidarity and collaboration between the member states during the assembly which helped to enhance the work of the World Health Assembly. Thanks were expressed to Director General Mrs Chan, the representatives of the secretariat, the vice presidents, and the “rapporteur” for their support, who were very professional. Interpreters and translators were very useful as well for the communication between member states, thanks to them.
Delegate of Senegal’s had the last word. He expressed his admiration for the way the work has been achieved. According to him courtesy, patience, constancy and a sense of compromise were present through the Committee. And the Chairman was specifically thanked for his work by the Senegalese delegate as he represented Madagascar and the African Region.
Therefore a very good overall impression had emerged from the work of the fourteenth meetings of Committee B during the WHA.
COMMITTEE B
Draft fourth report of Committee B
Document (draft) A60/62, containing one resolution entitled:
Health technologies
After a consultation of the assembly, no opposition was expressed to the adoption then declared by the Chairperson of the committee.
Item 12 (continued) Technical and health matters
Item 12.20 (continued) Public health, innovation and intellectual property: progress made by the Intergovernmental Working Group
Documents A60/27 and A60/B/Conf.Paper No.3 Rev.2
The Distinguished Delegate of Namibia presented the result of the work of the drafting group on the issue of Public health, innovation and intellectual property. He congratulated his co-workers in the draft group underlying the fact that the strength of such a group came from its diversity. He concluded by underlying the remaining sentence in brackets from line 3 to line 5 in paragraph 3 of operative clauses.
The efforts of the D.D. of Namibia were also thanked by the Chairperson.
The floor was then opened to comments and discussion. The D.D. of the U.S.A. took first the floor saying that his delegation was ready to make consensus provided certain changes in the text of the draft resolution. The D.D. of the U.S.A. proposed in fact several modifications:
• Preamble part of the draft resolution: change proposed in §2 (expression "diagnostic tools" on line 2 should be removed, becoming: "diagnostic TRIPS"). Such proposal received the support of the Australian Delegation.
• Operative clauses: §2 (second line, the expression "continue to" should precede the end of the sentence; "and continue to provide adequate resources to WHO"), §3.4 (a reformulation of the whole sentence is proposed). This last proposal was supported by the D.D. of Japan saying that the Delegation of Japan could not accept the statement in brackets.
The changes proposed by the American Delegation raised the opposition of several states among which were: Brazil, Chile, Kenya on behalf of the 46 African States, Thailand. The Delegation of Switzerland proposed to replace §3.4 in the text and to underlying that a compromise was reached yesterday. The Delegation has previously stated that the drat resolution, a very important and complex text was the result of a hazardous process and he added that the efforts done should not be underscored. According to his Delegation, the proposal from the D.D. of the U.S.A. can improve the reading of the text but are absolutely different from the draft document. He asked for a withdrawal of U.S.A.'s proposal.
Finally, as no agreement seemed to be reach between the two different positions the Chairman proposed to adopt the draft resolution as it was including the change on §2 of preamble. The D.D. of the U.S.A. declared that his Delegation reserved itself the right to express its opposition during the plenary.
The Resolution was adopted.
Draft fifth report of Committee B
The draft report was adopted without any comment or opposition in the committee.
Plenary Session
Item 8 : the draft reports of Committtee A (3rd, 4th, 5th and 6th) were adopted. Reports of Committee B (2nd, 3rd, 4th, 5th) were adopted.
However the US delegation declared that it couldn’t accepte the resolution contained in the 5th report of committee B : Public health, innovation and intellectual property as announced, as it cannot be considered as a consensus text. However the US did not intend to block to process.
In the closing Item, Dr. Robinson, chairman of Committe A took the floor to thank the delagations fir the good work accomplished during this 60th WHA. He particularly noted the constructive atmosphere in the dabate. His committe adopted 15 resolutions. 2 on the strategic medium plan and 13 on technical and healt issues. Only 2 working group were needed to discuss the draft reports. Dr. Robinson congratulate the Presidency and the DG Margaret Chan for her first WHA as director general.
Thomas Zeltner, the president of Committee B and swiss secretary of state for Public health, adresses the audience to acknoledge the work of the Assembly. He precised, that depite the comments, there is not yet a complete ban for smoking in public places in Switzerland, but a poposal is submitted to the Parliament and shall be submitted to approval. M. Zeltner said that his committee has been very effiecient and that its rapid work allowed to transfert some items from committee A. He thanked all delegations and the work of the Secretariat, the presidency, WHO staff and DG Dr. Chan.
mardi 22 mai 2007
Tuesday 22nd, MAY 2007
Committee B (morning)
The third draft report of Committe B (A60/609 was adopted).
Item 12.21 (continued) Technical and health matters: Progress reports
J. Reducing global measles mortality
Japan took the floor first to underline the need for more vaccine availability, especially in developing countries (DCs).
Iran said, on behalf of the Eastern Mediterranean countries, that special aid was still needed to maintain measles mortality reduction in DCs. The common goal is the eradication of measles within 2010 as the Millennium development goals (MDGs) state.
However, routine vaccination is still low in certain countries.
Guinea-Bissau, on behalf of the African region, reaffirmed its commitment to fight against measles and to reduce related mortality. The delegation also said, that maintaining the financing is necessary to preserve what has been done.
The Thai delegation: declared to have reduced by 60% its measles related mortality within 6 years. However measles rate remains at a high level and vaccine coverage needs to be further enhanced.
Oman suggested to double the dose of vaccine and to implement the catch up strategies.
The delegation of Bahamas said that the reduction of global measles mortality was the best investment to achieve goal 4 of the MDGs. Bahamas is now measles free, so could be the world.
K. Health metric Network
Benin, on behalf of the African region, asked for more data communication. Statistics should be improved in order to provide clear and updated information. The network and a good cooperation are necessary to achieve this.
Thailand asked for a better follow up of data and control. The network should also be used to reinforce the link between the regions, the cities and the Land.
The WHO Secretariat, responded to the interrogations and stated, that the partnership a t the country and institutional level should be strengthen. The program has made great progress and is been adopted by a good amount of countries.
Item 12.20 Public health, innovation and intellectual property: progress made by intergovernmental working group.
After the general debate on Friday and Monday, it was decided to create an intergovernmental working group to work on the draft resolution proposed by Brazil. Namibia was appointed chair of the group.
The delegation of Namibia reported that despite the willingness of the delegation to come to an agreement on a common text, the group after 4 hours of consultation did not come to a compromise on the text. The issue of Intellectual property being highly sensible!
Namibia proposed to close the session and to start consultations within the working group to come to an agreement on the text before the end of the WHA.
Some delegation (US, EU, Australia wanted to follow the agenda and first finish item 12.19 as scheduled before starting negotiations, as their delegations were not ready to debate due to other meetings going on)
Finally the Chairperson decided to back up the Namibian proposal to start immediately consultation of the working group and begin item 12.19 at 14:30 the afternoon.
Technical Meeting: 20th Anniversary of Safe Motherhood 13:00
The meeting was to keep inform delegations of the importance of the mother health and maternity issues. One woman dies every minute due to maternity linked issue.
What strikes us is that lives can very easily be saved because we know the causes and the remedies. I f we can save the mother we save the child.
The centrality of maternity health and reducing infant mortality is a central point in the development strategies.
Several invited speakers took the floor to express their views and actions. An British MP coordinating maternity health issues at the Parliament said that the MPs could undertake 3 actions: 1) lobbying decision makers 2) building up public supports 3) raising women’s expectations.
DG Margaret Chan was present and took the floor the underline her commitment to this important cause.
Different countries express their views in sustaining WHO and civil society actions.
The anniversary conference is to be held in London in October 18th- 20th 2007.
Special attention will be given to the link mother-child as a Nation’s health is defined by women’s health. The main idea is “Invest in women: it pays”.
COMMITTEE B (Afternoon)
Item 12
The purpose of the meeting was to discuss about the amendment made by the delegation of Mexico. This amendment consists, inter alia, in stressing the importance of medical devices. So, the distinguished delegate proposed to add "in particular medical devices" in the end of each paragraph of the second point dedicated to the requests.
The representative also proposed to delete the paragraph number (7) of the document.
Then, the representative of United States expressed his disagreement with this proposal and said he wanted to adopt the document as it is.
However, he made a proposal giving a new definition in the item 1 paragraph (5).
Mexico took the floor again to say that he accepted the US modifications.
As no objections has been made after this intervention, the chairman decided to adopt the amendments.
Thus, the meeting stopped at 16h00 and started again at 17h00
The second part of the meeting was consecrated to the adoption of the document A 60/A/conf. paper number 16.
The ambassador from Thailand (the president of the working group in the origin of the amendments) rejoiced with the spirit of compromise arising from the previous debates. While H.E. warmly called upon member states to adopt this document, he suggested bringing few modifications, inter alia, concerning centres collaborators.
As no objections has been made despite of these changes, the chairman decided to adopt the resolution.
Dr M. Chan ended the meeting by making a statement. The director-general began by congratulating those who had contributed to the adoption of this resolution. She also gave thanks to the whole delegation for the work they done, in particular H.E. the ambassador from Thailand.
Finally, the representative of Indonesia took the floor to say that this collaboration should carry on for other issues WHO related.
The third draft report of Committe B (A60/609 was adopted).
Item 12.21 (continued) Technical and health matters: Progress reports
J. Reducing global measles mortality
Japan took the floor first to underline the need for more vaccine availability, especially in developing countries (DCs).
Iran said, on behalf of the Eastern Mediterranean countries, that special aid was still needed to maintain measles mortality reduction in DCs. The common goal is the eradication of measles within 2010 as the Millennium development goals (MDGs) state.
However, routine vaccination is still low in certain countries.
Guinea-Bissau, on behalf of the African region, reaffirmed its commitment to fight against measles and to reduce related mortality. The delegation also said, that maintaining the financing is necessary to preserve what has been done.
The Thai delegation: declared to have reduced by 60% its measles related mortality within 6 years. However measles rate remains at a high level and vaccine coverage needs to be further enhanced.
Oman suggested to double the dose of vaccine and to implement the catch up strategies.
The delegation of Bahamas said that the reduction of global measles mortality was the best investment to achieve goal 4 of the MDGs. Bahamas is now measles free, so could be the world.
K. Health metric Network
Benin, on behalf of the African region, asked for more data communication. Statistics should be improved in order to provide clear and updated information. The network and a good cooperation are necessary to achieve this.
Thailand asked for a better follow up of data and control. The network should also be used to reinforce the link between the regions, the cities and the Land.
The WHO Secretariat, responded to the interrogations and stated, that the partnership a t the country and institutional level should be strengthen. The program has made great progress and is been adopted by a good amount of countries.
Item 12.20 Public health, innovation and intellectual property: progress made by intergovernmental working group.
After the general debate on Friday and Monday, it was decided to create an intergovernmental working group to work on the draft resolution proposed by Brazil. Namibia was appointed chair of the group.
The delegation of Namibia reported that despite the willingness of the delegation to come to an agreement on a common text, the group after 4 hours of consultation did not come to a compromise on the text. The issue of Intellectual property being highly sensible!
Namibia proposed to close the session and to start consultations within the working group to come to an agreement on the text before the end of the WHA.
Some delegation (US, EU, Australia wanted to follow the agenda and first finish item 12.19 as scheduled before starting negotiations, as their delegations were not ready to debate due to other meetings going on)
Finally the Chairperson decided to back up the Namibian proposal to start immediately consultation of the working group and begin item 12.19 at 14:30 the afternoon.
Technical Meeting: 20th Anniversary of Safe Motherhood 13:00
The meeting was to keep inform delegations of the importance of the mother health and maternity issues. One woman dies every minute due to maternity linked issue.
What strikes us is that lives can very easily be saved because we know the causes and the remedies. I f we can save the mother we save the child.
The centrality of maternity health and reducing infant mortality is a central point in the development strategies.
Several invited speakers took the floor to express their views and actions. An British MP coordinating maternity health issues at the Parliament said that the MPs could undertake 3 actions: 1) lobbying decision makers 2) building up public supports 3) raising women’s expectations.
DG Margaret Chan was present and took the floor the underline her commitment to this important cause.
Different countries express their views in sustaining WHO and civil society actions.
The anniversary conference is to be held in London in October 18th- 20th 2007.
Special attention will be given to the link mother-child as a Nation’s health is defined by women’s health. The main idea is “Invest in women: it pays”.
COMMITTEE B (Afternoon)
Item 12
The purpose of the meeting was to discuss about the amendment made by the delegation of Mexico. This amendment consists, inter alia, in stressing the importance of medical devices. So, the distinguished delegate proposed to add "in particular medical devices" in the end of each paragraph of the second point dedicated to the requests.
The representative also proposed to delete the paragraph number (7) of the document.
Then, the representative of United States expressed his disagreement with this proposal and said he wanted to adopt the document as it is.
However, he made a proposal giving a new definition in the item 1 paragraph (5).
Mexico took the floor again to say that he accepted the US modifications.
As no objections has been made after this intervention, the chairman decided to adopt the amendments.
Thus, the meeting stopped at 16h00 and started again at 17h00
The second part of the meeting was consecrated to the adoption of the document A 60/A/conf. paper number 16.
The ambassador from Thailand (the president of the working group in the origin of the amendments) rejoiced with the spirit of compromise arising from the previous debates. While H.E. warmly called upon member states to adopt this document, he suggested bringing few modifications, inter alia, concerning centres collaborators.
As no objections has been made despite of these changes, the chairman decided to adopt the resolution.
Dr M. Chan ended the meeting by making a statement. The director-general began by congratulating those who had contributed to the adoption of this resolution. She also gave thanks to the whole delegation for the work they done, in particular H.E. the ambassador from Thailand.
Finally, the representative of Indonesia took the floor to say that this collaboration should carry on for other issues WHO related.
lundi 21 mai 2007
Monday 21st, MAY 2007
Committee A (Morning)
Item 12.1 (continued) – Avian and pandemic influenza
Draft resolution has been adopted.
Item 12.10 (continued) – Working towards universal coverage of maternal, newborn and child health interventions: biennial report
Analysis of family planning services in low-income areas or countries indicates a lack of progress in their use. In many countries, particularly in Africa, fertility rates, population growth and unmet needs for family planning remain high. Continued high fertility rates and the demographic consequences of increasing numbers of births complicate attempts to improve health. Major gaps remain in the coverage of post-partum care; in some countries as many as 80% of women who give birth at home receive no such care. The urgent need for action to improve maternal, newborn and child health is commanding increased attention among other organizations in the United Nations system and partners and in global forums in general. The recommendation by the United Nations Secretary-General to the General Assembly at its sixtyfirst session, in September 2006,2 “to achieve universal access to reproductive health by 2015” as a new target under Millennium Development Goal 5 should also stimulate improvement in the rates of coverage.
Secretariat: collaboration with World Bank, UNICEF and NGO’s… is needed; A lot of progress has been achieved but it is not enough…
Item 12.5 (continued) – Malaria, including proposal for establishment of Malaria Day
Draft resolution has been adopted.
Item 12.6 (continued) – Tuberculosis control: progress and long-term planning
Draft resolution has been adopted.
Item 12.11 – Health promotion in a globalized world
Health promotion is a cornerstone of primary health care and a core function of public health.
Its value is increasingly recognized; it is both effective and cost-effective in reducing the burden of disease and in mitigating the social and economic impact of diseases. The links between health promotion, health, and human and economic development are widely acknowledged.
The Bangkok Charter confirms the need to focus on use of health promotion to address the determinants of health and identify action. Its four key commitments are to make promotion of health:
• Central to the global development agenda: strong intergovernmental agreements that improve health and collective health security and effective mechanisms for global governance for health are needed;
• A core responsibility for government as a whole: the determinants of health need to be addressed by all ministries at all levels of government;
• A key focus of communities and civil society: well-organized and empowered communities are highly effective in determining their own health, and are capable of encouraging governments and the private sector to be accountable for the health consequences of their policies and practices;
• A requirement for good corporate practice: the private sector has a responsibility to ensure health and safety in the workplace and to promote the health and well-being of employees, their families and communities, and to contribute to lessening wider impacts on global health
Germany underlined the great problem with the new migrations and their sanitary stakes. To reduce the disparities allows improving health conditions.
Cuba: Wish to enhance the collaboration with Medias - Modify the behavior to reduce the risks
Trinidad and Tobago: Prevention is one thing, but we don’t have to forget the “health consciousness”. Communication and Information will play a great role
Morocco: intellectual flexibility was not guaranteed, as promised in Doha. Innovation must not lead to monopoly. North-South cooperation is vital.
Ghana underlined the lack of financing the promotion of healthy environments and its promotion in the draft resolution.
Committe B (morning)
Item 12.20 on Public health, innovation and intellectual property was discussed as the general debate continued. The central points made by member states were to define clear objectives for R&D, for the secretariat to facilitate regional meetings, to translate the matrix draft (African region), to increase collaboration through the creation of an on going forum, the consultation and the elaboration of the document on intellectual property, and to facilitate access to medical support (Russia), making sure that the important resolutions are more clear and prioritized, to ensure access to necessary drugs in developing countries (China), finding ways and means to render the public health more accessible (Iran), finding ways to lower the prices of the medicines (Vietnam, Thailand). The NGOs, the FPMA and the MCM, that made statement during the meeting emphasized on the need of the IGWG to base itself on precise factual information in order to avoid mistakes and to license pattern pools to permit more affordable prices, try to convince the developers of the second generation of drugs. The doctors’ conclusions on the issues were:
_The working texts will be provided in July and will address the concerns formulated above as there was a high interest of the member states on the issue.
_As soon as the document will be provided the discussion will be more fruitful.
_There is a need to expand the pool of experts. 15 states have already contributed in proposing 42 experts.
Concerning the draft resolution A60/B/conf.paper no.3 Rev1, many member states expressed their gratitude to the director general’s support over the issue. Some amendments were proposed by Brazil who wished to add two paragraphs at the end of the preamble but the European Union showed her preoccupation towards these amendments and wished to know what would be the process followed by the WHO in this sense. Canada showed its anxiety to see the resolution narrow the IGWG work. The Chairman said that a redaction group would be in charge of this matter.
Item 12.19 Health technologies and the resolution EB120.R21. The Executive Board recommends the adoption of the resolution. An overall support to the resolution was stated by the member states. The need to reinforce the directives, to prevent the misuse of technical devices, to strengthen the WHO capacities in this area, and the necessity for equity were expressed. Five amendments to the resolution were proposed and the secretariat will take those into account by the 22nd of May. Hopefully the resolution will be adopted tomorrow.
Item 12.18 concerning Better medicines for children and the resolution EB120.R13 discussed during the last 30 minutes of the meeting. Russia stated that paediatric practice needs an extended number of medicines adapted to the children and under different forms.
Brazil wanted to assure more guarantees over the issue with the TRIPs work, but the United States of America expressed their desire for a moderated and measured approach for this complex problem, they prefer the word “promotion” to “guarantee”.
Technical Briefing – “WHO global action plan against Cancer”:
Cancer is a leading cause of death worldwide. From a total of 58 millions death worldwide in 2005, cancer accounts for 7.6 million (or 13%) of all deaths.
More than 70% of all cancer deaths in 2005 occurred in low and middle income countries. Deaths from cancer in the world are projected to continue rising, with an estimated 9 million people dying from cancer in 2015 and 11.4 million dying in 2030.
40% of cancer can be prevented (by a healthy diet, physically activity and not using tobacco). Another third of the cancer burden could be cured if detected early and treated adequately. For all remaining cancers, palliative care can improve quality of life.
WHO has adopted a global approach: “Prevent, cure, care, and manage for success”.
It is very important to access to healthy environments and the member states have to create nation plan action against the cancer.
COMMITTEE A (Afternoon)
Item 12 Technical health matters
Item 12.12
Integrating gender analysis and actions into the work of WHO
The majority of the member states welcomed the integration of gender analysis and actions in the work of WHO. They also thanked the Secretariat for its work and the quality of its report.
However, various states proposed amendments to the draft strategy. The Distinguished Delegate of Thailand proposed to include the "study" as a determining factor of gender inequality. The D.D. of Sweden proposed to replace "gender family health care" in paragraph 2.4 by "agenda equality perspective"; to replace "too" in paragraph 2.6 by "as providers of" and to add after "publication" on paragraph 3.5: "including relevant documentation presented to the Executive Board and the World Health Assembly". The D.D. of Switzerland also proposed some changes (§2.1, §2.4, §3.4).
The D.D. of Japan expressed the viewpoint of his country concerning the need to take into consideration the cultural background of each country in the implementation of the strategy. He also insisted on the necessary quality of indicators in that sensitive field. The D.D. of South Africa insisted on the establishment of strong capacity-building partnerships and a share of skills in monitoring and evaluation of the strategy's implementation.
The Chairman proposed that the Secretariat would provide a new draft resolution that includes the amendments proposed so that the whole assembly would have access to the new version as a work basis.
Item 12.13
Workers' health: draft global plan of action
Once again, the delegations warmly welcomed the report proposed by the Secretariat.
The D.D. of Germany, on behalf of the European Union emphasized the benefits of ILO/WHO cooperation, particularly in the field of workers' health. He also proposed two friendly amendments.
Some delegations proposed to remove or add some expressions in the draft resolution: Philippines, Thailand, The Sultanate of Oman, Cameroun, the Russian Federation, Greece and Kenya.
The D.D. of Portugal after having stressed the alignment of his delegation on the E.U. statement, highlighted the particular situation of migrant workers and the effect of their working conditions on their health.
On behalf of Saudi Arabia, Kuwait, Qatar, Bahrain, Yemen, Syria, Jordan, Liban, the D.D. of the Sultanate of Oman proposed to add in the 2007-2013 Action Plan the expression "travaillleurs sous contrats" as those Gulf countries have in common that category to distinguish the migrant.
As for the previous item, the Secretariat will provide a new draft document that will include the proposed amendements.
Item 12.14
Health systems: emergency-care systems
This item was only introduced explaining the choice of the expression "emergency-care systems" as an expression covering a wider scope than "emergency-care" alone. There was no time left to keep the discussions on that item and the meeting was adjourned.
Committee B (afternoon)
This seventh meeting of the Committee B was essentially a discussion to follow up past resolutions on technical and health matters.
Before beginning the review, item 12.20 on public health (innovation and intellectual property) after amendment has been adopted.
Item 12.21 Technical and health matters: Progress reports
G. sustaining the elimination of iodine deficiency disorders (resolution WHA 58.22)
Peru took the floor to underline the importance of the issue. Reaffirming that a lack of iodine in alimentation causes serious health damages such as brain disturbance, vision impairment….
A special care should be given to pregnant women who are particularly vulnerable and also because the baby can also greatly suffer from a low iodine alimentation.
Iran emphasizes the need the build up national capacities but also insisted on institutional cooperation between the WHO and relevant partner organizations.
The Canadian delegation found, that the key was the systemic distribution of iodized salt to needed population.
A. Improving the containment of antimicrobial resistance (resolution WHA58.27)
Denmark insisted on the information need and the elaboration of a global response to this issue.
Iran sees this issue of medicine ineffectiveness as a health system issue. Many medicines are not properly used and too often are given without precautions.
B. Implementation by WHO of the recommendation of the Global Task Team on improving AIDS Coordination among multilateral institutions and international donors. (Resolutions WHA59.12)
The South African delegation said it was important to make “money work”, in other words we need effective cooperation and follow up of the aid. There is also a need for more experience sharing among countries and institutions. This is important to have a better global understanding but then apply local skills and approaches.
The ICRC says that the battle of AIDS should be tackled at the community level.
C. World report on violence and health implementation of recommendations
The Jordanian delegation underlines the scourge of violence, which seems to be universal and part of the human condition. The delegation ask for money resources on that particular issue, that is sometimes forgotten, as it not a ‘diseases’ but which can cause serious physical and mental sufferings.
Norway recommended a more close work with the UNICEF concerning the issue of children and violence.
D. Promotion of road safety (resolution WHA57.10)
E. Disability, including prevention (resolution WHA58.23)
Angola reaffirmed the need to tackle this issue, which is another source of discrimination between rich and poor countries. Disability is tightly linked for poverty and other development issues. There is also a need in developing countries for better information data on disability. Resources mobilization should be a priority!
F. Cancer prevention and control (resolution WHA58.22)
Uganda reaffirmed the need to universal access to prevention an control. But also the importance of cancer research on diagnostic.
Bahrain on behalf of the Eastern Mediterranean countries says that some countries were left apart. Knowledge and experience should be made available for any country.
An effective control and prevention is particularly needed for breast cancer.
H. Strengthening active and healthy ageing
I Emergency preparedness and response (resolution WHA59.22)
Congo insisted on the importance of emergency health. It can be because of a natural disaster or as the result of an armed conflict, which has dramatic consequences for civilians, creating internally displaced persons (IDP) or refugees in other countries.
Botswana said that this issue was to be underlined in the perspective of the development agenda and that a sector approach was needed.
Item 12.1 (continued) – Avian and pandemic influenza
Draft resolution has been adopted.
Item 12.10 (continued) – Working towards universal coverage of maternal, newborn and child health interventions: biennial report
Analysis of family planning services in low-income areas or countries indicates a lack of progress in their use. In many countries, particularly in Africa, fertility rates, population growth and unmet needs for family planning remain high. Continued high fertility rates and the demographic consequences of increasing numbers of births complicate attempts to improve health. Major gaps remain in the coverage of post-partum care; in some countries as many as 80% of women who give birth at home receive no such care. The urgent need for action to improve maternal, newborn and child health is commanding increased attention among other organizations in the United Nations system and partners and in global forums in general. The recommendation by the United Nations Secretary-General to the General Assembly at its sixtyfirst session, in September 2006,2 “to achieve universal access to reproductive health by 2015” as a new target under Millennium Development Goal 5 should also stimulate improvement in the rates of coverage.
Secretariat: collaboration with World Bank, UNICEF and NGO’s… is needed; A lot of progress has been achieved but it is not enough…
Item 12.5 (continued) – Malaria, including proposal for establishment of Malaria Day
Draft resolution has been adopted.
Item 12.6 (continued) – Tuberculosis control: progress and long-term planning
Draft resolution has been adopted.
Item 12.11 – Health promotion in a globalized world
Health promotion is a cornerstone of primary health care and a core function of public health.
Its value is increasingly recognized; it is both effective and cost-effective in reducing the burden of disease and in mitigating the social and economic impact of diseases. The links between health promotion, health, and human and economic development are widely acknowledged.
The Bangkok Charter confirms the need to focus on use of health promotion to address the determinants of health and identify action. Its four key commitments are to make promotion of health:
• Central to the global development agenda: strong intergovernmental agreements that improve health and collective health security and effective mechanisms for global governance for health are needed;
• A core responsibility for government as a whole: the determinants of health need to be addressed by all ministries at all levels of government;
• A key focus of communities and civil society: well-organized and empowered communities are highly effective in determining their own health, and are capable of encouraging governments and the private sector to be accountable for the health consequences of their policies and practices;
• A requirement for good corporate practice: the private sector has a responsibility to ensure health and safety in the workplace and to promote the health and well-being of employees, their families and communities, and to contribute to lessening wider impacts on global health
Germany underlined the great problem with the new migrations and their sanitary stakes. To reduce the disparities allows improving health conditions.
Cuba: Wish to enhance the collaboration with Medias - Modify the behavior to reduce the risks
Trinidad and Tobago: Prevention is one thing, but we don’t have to forget the “health consciousness”. Communication and Information will play a great role
Morocco: intellectual flexibility was not guaranteed, as promised in Doha. Innovation must not lead to monopoly. North-South cooperation is vital.
Ghana underlined the lack of financing the promotion of healthy environments and its promotion in the draft resolution.
Committe B (morning)
Item 12.20 on Public health, innovation and intellectual property was discussed as the general debate continued. The central points made by member states were to define clear objectives for R&D, for the secretariat to facilitate regional meetings, to translate the matrix draft (African region), to increase collaboration through the creation of an on going forum, the consultation and the elaboration of the document on intellectual property, and to facilitate access to medical support (Russia), making sure that the important resolutions are more clear and prioritized, to ensure access to necessary drugs in developing countries (China), finding ways and means to render the public health more accessible (Iran), finding ways to lower the prices of the medicines (Vietnam, Thailand). The NGOs, the FPMA and the MCM, that made statement during the meeting emphasized on the need of the IGWG to base itself on precise factual information in order to avoid mistakes and to license pattern pools to permit more affordable prices, try to convince the developers of the second generation of drugs. The doctors’ conclusions on the issues were:
_The working texts will be provided in July and will address the concerns formulated above as there was a high interest of the member states on the issue.
_As soon as the document will be provided the discussion will be more fruitful.
_There is a need to expand the pool of experts. 15 states have already contributed in proposing 42 experts.
Concerning the draft resolution A60/B/conf.paper no.3 Rev1, many member states expressed their gratitude to the director general’s support over the issue. Some amendments were proposed by Brazil who wished to add two paragraphs at the end of the preamble but the European Union showed her preoccupation towards these amendments and wished to know what would be the process followed by the WHO in this sense. Canada showed its anxiety to see the resolution narrow the IGWG work. The Chairman said that a redaction group would be in charge of this matter.
Item 12.19 Health technologies and the resolution EB120.R21. The Executive Board recommends the adoption of the resolution. An overall support to the resolution was stated by the member states. The need to reinforce the directives, to prevent the misuse of technical devices, to strengthen the WHO capacities in this area, and the necessity for equity were expressed. Five amendments to the resolution were proposed and the secretariat will take those into account by the 22nd of May. Hopefully the resolution will be adopted tomorrow.
Item 12.18 concerning Better medicines for children and the resolution EB120.R13 discussed during the last 30 minutes of the meeting. Russia stated that paediatric practice needs an extended number of medicines adapted to the children and under different forms.
Brazil wanted to assure more guarantees over the issue with the TRIPs work, but the United States of America expressed their desire for a moderated and measured approach for this complex problem, they prefer the word “promotion” to “guarantee”.
Technical Briefing – “WHO global action plan against Cancer”:
Cancer is a leading cause of death worldwide. From a total of 58 millions death worldwide in 2005, cancer accounts for 7.6 million (or 13%) of all deaths.
More than 70% of all cancer deaths in 2005 occurred in low and middle income countries. Deaths from cancer in the world are projected to continue rising, with an estimated 9 million people dying from cancer in 2015 and 11.4 million dying in 2030.
40% of cancer can be prevented (by a healthy diet, physically activity and not using tobacco). Another third of the cancer burden could be cured if detected early and treated adequately. For all remaining cancers, palliative care can improve quality of life.
WHO has adopted a global approach: “Prevent, cure, care, and manage for success”.
It is very important to access to healthy environments and the member states have to create nation plan action against the cancer.
COMMITTEE A (Afternoon)
Item 12 Technical health matters
Item 12.12
Integrating gender analysis and actions into the work of WHO
The majority of the member states welcomed the integration of gender analysis and actions in the work of WHO. They also thanked the Secretariat for its work and the quality of its report.
However, various states proposed amendments to the draft strategy. The Distinguished Delegate of Thailand proposed to include the "study" as a determining factor of gender inequality. The D.D. of Sweden proposed to replace "gender family health care" in paragraph 2.4 by "agenda equality perspective"; to replace "too" in paragraph 2.6 by "as providers of" and to add after "publication" on paragraph 3.5: "including relevant documentation presented to the Executive Board and the World Health Assembly". The D.D. of Switzerland also proposed some changes (§2.1, §2.4, §3.4).
The D.D. of Japan expressed the viewpoint of his country concerning the need to take into consideration the cultural background of each country in the implementation of the strategy. He also insisted on the necessary quality of indicators in that sensitive field. The D.D. of South Africa insisted on the establishment of strong capacity-building partnerships and a share of skills in monitoring and evaluation of the strategy's implementation.
The Chairman proposed that the Secretariat would provide a new draft resolution that includes the amendments proposed so that the whole assembly would have access to the new version as a work basis.
Item 12.13
Workers' health: draft global plan of action
Once again, the delegations warmly welcomed the report proposed by the Secretariat.
The D.D. of Germany, on behalf of the European Union emphasized the benefits of ILO/WHO cooperation, particularly in the field of workers' health. He also proposed two friendly amendments.
Some delegations proposed to remove or add some expressions in the draft resolution: Philippines, Thailand, The Sultanate of Oman, Cameroun, the Russian Federation, Greece and Kenya.
The D.D. of Portugal after having stressed the alignment of his delegation on the E.U. statement, highlighted the particular situation of migrant workers and the effect of their working conditions on their health.
On behalf of Saudi Arabia, Kuwait, Qatar, Bahrain, Yemen, Syria, Jordan, Liban, the D.D. of the Sultanate of Oman proposed to add in the 2007-2013 Action Plan the expression "travaillleurs sous contrats" as those Gulf countries have in common that category to distinguish the migrant.
As for the previous item, the Secretariat will provide a new draft document that will include the proposed amendements.
Item 12.14
Health systems: emergency-care systems
This item was only introduced explaining the choice of the expression "emergency-care systems" as an expression covering a wider scope than "emergency-care" alone. There was no time left to keep the discussions on that item and the meeting was adjourned.
Committee B (afternoon)
This seventh meeting of the Committee B was essentially a discussion to follow up past resolutions on technical and health matters.
Before beginning the review, item 12.20 on public health (innovation and intellectual property) after amendment has been adopted.
Item 12.21 Technical and health matters: Progress reports
G. sustaining the elimination of iodine deficiency disorders (resolution WHA 58.22)
Peru took the floor to underline the importance of the issue. Reaffirming that a lack of iodine in alimentation causes serious health damages such as brain disturbance, vision impairment….
A special care should be given to pregnant women who are particularly vulnerable and also because the baby can also greatly suffer from a low iodine alimentation.
Iran emphasizes the need the build up national capacities but also insisted on institutional cooperation between the WHO and relevant partner organizations.
The Canadian delegation found, that the key was the systemic distribution of iodized salt to needed population.
A. Improving the containment of antimicrobial resistance (resolution WHA58.27)
Denmark insisted on the information need and the elaboration of a global response to this issue.
Iran sees this issue of medicine ineffectiveness as a health system issue. Many medicines are not properly used and too often are given without precautions.
B. Implementation by WHO of the recommendation of the Global Task Team on improving AIDS Coordination among multilateral institutions and international donors. (Resolutions WHA59.12)
The South African delegation said it was important to make “money work”, in other words we need effective cooperation and follow up of the aid. There is also a need for more experience sharing among countries and institutions. This is important to have a better global understanding but then apply local skills and approaches.
The ICRC says that the battle of AIDS should be tackled at the community level.
C. World report on violence and health implementation of recommendations
The Jordanian delegation underlines the scourge of violence, which seems to be universal and part of the human condition. The delegation ask for money resources on that particular issue, that is sometimes forgotten, as it not a ‘diseases’ but which can cause serious physical and mental sufferings.
Norway recommended a more close work with the UNICEF concerning the issue of children and violence.
D. Promotion of road safety (resolution WHA57.10)
E. Disability, including prevention (resolution WHA58.23)
Angola reaffirmed the need to tackle this issue, which is another source of discrimination between rich and poor countries. Disability is tightly linked for poverty and other development issues. There is also a need in developing countries for better information data on disability. Resources mobilization should be a priority!
F. Cancer prevention and control (resolution WHA58.22)
Uganda reaffirmed the need to universal access to prevention an control. But also the importance of cancer research on diagnostic.
Bahrain on behalf of the Eastern Mediterranean countries says that some countries were left apart. Knowledge and experience should be made available for any country.
An effective control and prevention is particularly needed for breast cancer.
H. Strengthening active and healthy ageing
I Emergency preparedness and response (resolution WHA59.22)
Congo insisted on the importance of emergency health. It can be because of a natural disaster or as the result of an armed conflict, which has dramatic consequences for civilians, creating internally displaced persons (IDP) or refugees in other countries.
Botswana said that this issue was to be underlined in the perspective of the development agenda and that a sector approach was needed.
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